Surgical appliance.



0.1. FILLING & H. R. PIERCE.

SURGICAL APPLIANCE.

APPLlCATlON FILED MAY 26. 19!].

1 ,27 9, 1 54 Patented Sept. 17, 1918.

- 2 SHEETS-SHEET 1.

Fly .1. 14 3 11 J5 CHARLES J. FILLING, OF LANsnoWNE, ANDI-IARVEY R. PIERCE,.OF P ILADELP IA,

' 1 PENNSYLVANIA. 1 r y suEGIoAL APPLIANCE.

Sbecification'of Letters Patent'. Patntd Sept, 17,

Application filed MayZG, 1917. SerialNo. 171,077.

To all whom z'tmay concern:

Be it known that we, CHARLES J .PILLING,

a citizen of the United States, residing at] and whose post-olticeaddress is Lansdowne, county of Delaware, and State of Pennsylvania, and HARVEY R. PIERCE, a citizen of the United States, residing at and Whose 'post-oflice address is 1801Ch'estnut street, city and county of Philadelphia,and "State of Pennsylvania, have invented certain new and useful Improvements in Surgical Appliances, of'which the'following is'a specification. j

Our invention relates to improvements in surgical appliances; and the object ofv our invention is to provide a novel, simple and etlicient appliance for use in connectionwith the treatment of cavities for various purposes-such as the sterilization thereofby the introduction of the well known Dakins solution. I v

Gur invented appliance includes a syringe member for closing the entrance to the cavity to 'be treated, and a tube extending through the member, and adjustable therein, for the introduction of the Dakins solution or other liquid," and means operative to adjust the tube within the cavity and relatively to the member. Our appliance also includes an introducing or inserting member, by the aid of wh-ichthe member may be inserted into the entrance. to the cavity to be treated.

' The appliance'is particularly, though'not exclusively, adapted for use in the treatment of the uterus, and the member, introducer and tube,adjuster,,shown in the drawings hereinafter referred to aredesigned and adapted for this particular use.

With the above named object in view, our invention consists in the novel construction and combinations of parts hereinafter described and claimed.

In the accompanying. drawings, illustrating our invention,

Figure 1 is a side 'viewof our improved surgical appliance. showing the 'positionof the parts prior to the insertion of the syringe member.

2 is a view, simil'arto Fig. .l,fshow in'g theposition of the parts-after theinserthe appliance, showing the position of the adjustable therein. The portions of the tion of'the syringe membenand the adjust;- ment. .of the tubes relatively thereto.

Flg. 3 is a longitudinal section through parts after the release ofthe tubes'following the adjustment thereof. 5 Fig. l'is a top View of thesyringememher and the tubes, as shownin Fig. l.

Fig. 5 is a section through thesyringe member and tubes, online 55 of Fig. 1. b Fig. 6 is a side View of the syringe memer. I 1 I Fig. 7 is a longitudinal section through the syringe member on line 7."7 of Fig.6.

Referring tothe drawings, 2 designates a syringe member which, as herein-illustrated, is substantially cylindrical in form .and is adapted to be inserted into and'to close the entrance to-the cavity to be -treated.- The end 3 of the member is adapted to be first inserted into the entrance to the cavity during the insertion of the member. This end 3 is herein termed the inner end of the r member, and the opposite end thereof is 75 herein termed-the outer-end of the'member.

The member 2'is' provided with four pasv sages or openings 4iand 6' whichextend longitudinally therethrough: and which are spaced around the axis ofthe member, as clearly shown in Fig. The openings 4 and 6 are adapted to receive two flexible tubes 8 and'9, respectively, which extend therethrough and which arelongitudinally tubes 8 and 9 which extend beyond the inner end of the member'2 are formed into loops 10 and ll'which cross each other, as clearly shown in the drawings. The loop portions 10' and 11' are adapted to enter the cavity to 'be treated,and they are-provided with spaced perforations 12 to permit liquid 1 to flow from the tubes and into the cavity. The end portions of the tubes 8 and 9, extending beyond the outer end'of the member '2, are adapted to be connected to any suitable source of'supply of Dakins solution or other, liquid, located to permit the liquid to fio'w -bygravity through the tubes 8 and 9 and into the cavity; or instead of permitting theliquid to flow into the cavity by gravity, any suitable means may be employed to force the liquid through the tubes and into the cavity.

The design of the syringe member herein illustrated is particularly adapted for use in treating the uterus. The outer end of the member 2 is provided with an outwardlyprojecting, annular flange 13 adapted to engage the external 0s, of'the uterus to limit the inward movement of the member; and the inner end of the member is provided with an outwardlyprojecting, annular flange 14 'of'less diameter than the flange 13 and is adapted to be passed through the, cervical canal and to engage the internal os circumferential grooves 16 are connected to the tube openings et and 6 by radial passages 19; and'thecircumferential grooves 16 are connected by-angularly disposed grooves 20 which radiate from the outer end of the passages 19.

1 The purpose of the passages 19 is to permit liquid from the tubes 8 and 9 to flow to the grooves 16, 17 and 20; the purpose of the passage 18 is to permit liquid to pass out from the grooves 17 when the member is in use; and the purpose ofthe grooves 16, 17 and 20 is to permit liquid to reach all parts of the cervical wall.

, As a convenient-means to insert the mem ber' 2 into the cervix, we provide an introducing or inserting member 21 comprising a hollow handle 22 .and a tubular arm 23 extending therefrom and suitably curved to conform to the vagina. The member 2 is adapted to be detachably mounted on the free end of'the arm 23by inserting said free end into the outer end of the central opening 15in thetmember; and the downward movement of the member 2 upon'the arm 23 is limited by an outwardly-projecting, annular flange 2 on the arm 23; whereby, when the arm 23 carryingthe member 2, as shown in Fig; 1, is introduced into the vagina,the arm 23 will carry the member therewith and the member may be subsequently inserted into the os of the uterus by the aid of the inserting'membe'r 21. After the member 2 has beenthus inserted, the arm 23 is withdrawn from the member 2 and the vagina, leaving the member in place in the os of the uterus.

Toadjustthei tubes 8 and 9 relativelyto the member 2, and to project the loop portions 10 and 11 of the tubes into the uterus,

after the insertion of the member 2, as just described, we provide the following device: Slidable within the hollow handle 22 and the tubular extension 33 thereof is a rod or arm'2 5 having a thinupper portion which.

is adapted to conform to the curved portion of the tubular arm 23. Arranged adjacent to the upper end of the arm 25 is a spring arm 27, the lower end of which is secured to the'arm 25. The upper or freeend of the spring arm 27 terminates opposite to the adjacent free end of the arm 25; and the adj acent free ends of the arms 25tand 27 are normally separated, as shown in Fig. 3'; and the free end of thear'm 27 is adapted to be sprung toward the. free end of the arm 25 from the position shownin Fig.3 to the position shown in Fig. 2. These adjacent free ends of the arms 25 and 27 are provided with opposing jaws 28 and 29,'respectively, which are adapted to receive the tubes 8 and 9 and hold or clamp them therein when the arm 27 is sprung to move the jaw 28 toward the jaw 29,- as shown in Figs. 1, 2'and 4. l

The arm 27 is adapted to be sprung toward the arm 25 to close the jaws 28 and 29 by a ring 30 which surrounds the arms 25 1 and '27 and which is carried by the adjacent end of a long, thin arm or part 31 which extends through the inserting member 21, adjacent to the arm 25. The arm 31 is provided with a guide sleeve 32 on its lower end which surrounds the arm 25 and a guide sleeve 33 intermediate of its ends which. surrounds the arm 25. The guide sleeve 32 is provided'with a thumb piece 3 1, by means of which the arm 31 maybe moved longitu-' dinally, guided by the arm.25, by the thumb of the hand of a physician or surgeon grasps the lower end of the arm 25. When the arm 31 is thus moved upwardly to the position shown-in. Fig. 2, the ring 30 operates to move the arm 27 toward the arm 25 and close the jaws 28 and 29; and, when the arm 31 is moved clownwardly, or in the reverse direction, the ring 30 o erates to permit the arm 27 to spring bac to its normal position, shown in Fig. 3, to open the jaws 28 and'29. j

v The arms 25 .and 31 are bodily movable within the inserting member 21 and the syringe member 2 thereon, to adjust the tubes 8 and 9 relatively to the member 2 when the tubes are clamped within the jaws 28 and 29; and, to limit the bodily upward movement of thearms 25 and 31, when the 28 and 29, a stop sleeve 35 is placed upon the arm orrod 25 and provided with a set screw 36 to clamp the sleeve 35in different 7 positions of adjustment on the arm 25. -This stop sleeve 35 is adapted .to engagethe bottom of the handle 22 of the members 21 and limit the upward' movement of the arm 25,

The upper end of'the arm 31, as well as the arm 25, is-made sufliciently flexible to conform to the curved portion of the tubular arm 23 of the inserting members 21; and the arms'25 and 31 are" adapted to be bodily withdrawn from within the inserting member 21 for any desired purpose.

The operation of the appliance isa's follows: Y Y

' The syringe member 2 is placed upon the end of the arm 23 of theinserting member 21, the tubes 8 and 9 are passed through the openings a and '6 iirtlie member 2 and the loop portions 10 and 11 of the tubes 4: and 6 are clamped within the jaws 28 and 29 and the parts occupy the position shown in Figs.

land 1. Measurement of the uterus to-be treated is taken with the aid of a suitable uterine sounding instrument, and,'after the distance between the internal 0s and the fundus or anterior wall is determined, the

stop'sleeve '35 is placed upon the arm 25 a corresponding distance or a slightly less distance from the handle 22.

Now, the physician or surgeon grasps the handle 22, and by the aid of the inserting member 21,'passes the member 2 in through the vagina and inserts it into the cervix of the uterus until the outer flange 13 of the pes'sary comes into engagement 'With'the ex ternal os.' Duringthe insertion ofthe member 2 the cervix-is expanded slightly thereby and-after the inner flange 1a passes the internal os, the cervix contracts around the body of the member 2and the inner flange '14 'prevent'sthe accidental withdrawal of the member 2 from the cervix. g The arms 25 and 31 are now moved bodily inward untilthe stop sleeve 35 engages the handle 22 thereby drawing the loop portions 10 and 11 of the tubes 8 and 9 into the uterus and into the position shown in Fig. '2, the engagement of the sleeve 35 with thehandle '22 preventing the projection of the jaws 28 and 29 and the tubes 8 and 9 far, enough. to puncture or injure the fundus'or the wall of the uterus. i

This being done, the physician grasps the outer end of the rod or arm 25 and places his thumb upon the part 3atand operates the sleeeve 32 to move the arm 31'outwardly, thereby moving the ring 30 outwardly and permittitng the jaws 28 and29 to separate and release the tube loops l0an'd 11; and

following this the inserting member 21 and thetube adj usting arms 25 and 31 are bodily withdrawn from the member 2 and from the vagina,leaving the'member 2 in place in the cervical canal and the outer end portions of the tubes extending from the vagina. The uterus is now packed with gauze which is inserted through the central-opening. 15 of the member 2 with the aid of'a suitable uterine packing instrument. The gauze thus inserted serves the double purpose of retaining and distributing liquid within the uterus and spreading the loop portions 10 and 11 of the tubes and holding them in positioni The central opening 15 of the member '2 is also packed with gauze'to close the same. I

'The outwardly extending end portions of the tubes 8 and 9 are now'connected to a suitable source of supply of the Dakins solution or other li uid to beintroduced to the uterus, and the liquid ispermitted to flow through the tubes Sand 9 and out through the -perforations' 12 therein by gravity, or the liquid is forced through the tubes and "out through the perforations therein. i j The liquid passes from the perforations 12 into the passages 4: and 6 ofthe member 2 and'into the gauze within? the uterus and the gauze becomes saturated with theliquid and carries it to all parts of the walls of the uterus. The liquid passes from the openings 4 and Gthrough the openings 19 and fills the grooves 16, 17 and 20 and from themfinds its Way to all parts of the cervical canal; and, further, the liquid enters the grooves 17 from the gauze within the uterus and drains through the passages 15 and 18 to a strip of gauze which is'inserted t0 extend from within the opening 15 out through the vagina. I e Thus theentire area of the uterus and its cervical canal is subjected to the action of the liquid; The uterus is usually repacked with fresh gauze and the liquid is introduced to the fresh gauze, at certain intervals during the processor the treatment. V At the completion of the process of the treatment, the member 2 is withdrawn from the cervix and the vagina by a suitable forceps or other means or by grasping the outwardly projecting ends of the tubes 8 and 9 by hand and pulling the member and tubes from their'inserted position.

We claim: l. A syringe member having a tube extending through and beyond the ends thereof, the member being adaptedtobe placed in the entrance to a cavity to betreated, and

the tube being adapted to permit the pasmeans causing the syringe member to move with the insertlng member when it 1s moved 1n one direction and to permit the withdrawal of the inserting member fromthe syringe memberwhen the inserting member is moved in the reverse direction.

2. A- syringe member having a tube extending through and beyond the ends thereof, and having "an opening therein for the reception of an insertingmember, the syringe member being adapted to be placed inthe entrance to a cavity to be treated, and the tube being adapted to permit the passage of liquid into said cavity for the treatment thereof, an inserting member having an end portion adapted to be placed in the opening in the syringe member and to be withdrawn therefrom after-the insertion of the syringe member in the entrance of an infected cavity, said inserting member being provided with means causingthe syringe member to move with the inserting member when it is moved in one direction and to permit the withdrawal of the inserting member fromthe syringe member when. the inserting member is moved in the reverse direction.

3. A syringe member having a flexible tube extending therethrough and adjustable therein, the syringe memberbeing adapted to be placed in the entrance to a cavity to be treated, and the tube being adapted to permit the passage of liquid into said cavity for V the treatment thereof, and means adjustable entirely through and beyond the syringe member operative to adjust the tube relatively to the same.

4. A syringe member having a tube extending therethrough and adjustable therein, the syringe member being adapted to be placed in the entrance to a cavity to be treated, and the tube being adapted to permit the passage of liquid into said cavity for the treatment thereof, a hollow inserting member removably engaged with the syringe member, and means extending through said inserting member and operative to ad ust the tube relatively to the syringe member.

5. A syringe member having a tube extending therethrough and adjustable therein, the syringe member being adapted to be placed in the entrance to a cavity to be treated, and the tube being adapted to permit the passage of liquid into said cavity for the treatment thereof, and means OPQIittlVe to adjust the tube "relatively to the syringe member, said means being movable relatively to the syringe member and including gripping aws for the tube and means operative to open and close the jaws. V

6. A syringe member having a tube extending therethrough and adjustable therein,.the syringe member being adapted to be placed in the entrance to a cavity to be treated, and the tube being adapted to permlt the passage of liquid into sa d cavity. for the .the syringe member being adapted to be placed in the entrance to a cavity to be treated, and the tube being adapted to per-mit the passage of liquid into said cavity for the treatment thereof, and means operative to adjust the tube relative tothe syringe member, said means comprising an arm having a bifurcated end provided with normally spaced jaws adapted to be sprung toward each other toclamp said tube and to spring apart to release said tube, and a part slidable on said arm and having a ring encircling the same adapted to close and to permit said jaws to open when said part is moved longitudinally on said arm. 7

8. A syringe member having a tube extending therethrough and adjustable therein, the syringe member being adapted to be placed in the entrance to a cavitytobe treated, and the tube being adapted to permit the passage of liquid into said cavity for the treatment thereof, a hollow inserting member removably engaged with the syringe member, a movable arm provided with means to engage and adjust said tube when said arm is moved relatively to said inserting member, and an adjustable stop carried by said arm and adapted to engage said inserting member to limit the movement of the arm relatively to the inserting member.

9. A syringe member havingtwo openings extending longitudinally therethrough, and a flexible; tube having a loop formed therein beyond one end of said member and extend ing from-said loop through said openings, the loop portion of said tube having spaced perforations therein, said tube being adjust- .able within said openings, and means operative to adjust the tube relatively to the said member.

10.,A syringe member havingfour openings extending longitudinally therethrough, a flexible tube having a loop formed therein beyond one end of said member and extending from said loop through two of said openings, and a second flexible tube having a loop formed therein beyond the same end of said member and crossing the first named loop and extendin from its loop through two of 7 said openings, the loop portion ofsaid tubes having spaced perforations therein, said tubes being adjustable within said openings,

and means operative to adjust the tubes relacommunicating with said opening, and a tube extending through sald open ng and beyond said member and havmg discharge perforations therein within and beyond said opening.

12. A syringe member comprising a cylindrical body having internal openings extending therethrough, and external, annular groove-s communicating with said openings.

13. A syringe member comprising a cylindrical body having internal openings extending therethrough, and external, longitudinal and circumferential grooves communicating with each other and with said openings.

14. A syringe member comprising a cylin- Copies of this patent may be obtained for five cents each, by addressing the "Commissioner of Patents,

drical body having an outwardly extending flange on each end thereof, and grooves in the surface thereof extending through and beyond one of said flanges.

' 15. A syringe member comprising a cylindrical body having an outwardly extending tures hereto.

CHARLES J. FILLING. HARVEY R. PIERCE.

Washington, D. 0. 

